- Over 95% of Aetna's prior authorizations are approved within 24 hours.
- Introduction of bundled prior authorizations for cancer patients to reduce administrative burden.
- Aetna's Clinical Collaboration Program aims to reduce hospital readmissions through on-site nurse collaborations.
Aetna, a CVS Health company (CVS, Financial), is set to enhance the healthcare experience by simplifying prior authorization processes and improving patient care navigation. A significant focus is on bundling prior authorizations for cancer patients needing MRI/CT scans, with plans to extend this to cardiology and musculoskeletal conditions before the end of the year. Impressively, Aetna's prior authorization approval rate surpasses 95% within 24 hours, showcasing its commitment to reducing administrative hurdles.
The Aetna Clinical Collaboration program further exemplifies the company's dedication to improving healthcare transitions. By embedding nurses directly within healthcare facilities, Aetna facilitates smoother patient transitions from hospital settings to home or community care, aiming to reduce 30-day readmission rates significantly for Medicare Advantage members initially, with a planned expansion to commercial members.
Technological enhancements are also a part of Aetna's strategic approach, with upgrades to the Aetna Health app. These include Smart Compare, which assists members in matching with appropriate providers, and real-time updates on prior authorization statuses. Such features are designed to provide patients with greater transparency and ease of navigation through their healthcare journeys.
Through these initiatives, Aetna is not only addressing key pain points in the healthcare system but also aligning itself with industry trends towards value-based care models, thereby enhancing patient outcomes and reducing costs for healthcare providers.
